Page 22 - CIBEREHD-2015-eng

Scientific Programmes
Hepatic and Gastrointestinal Oncology
COORDINATOR: DR. JORDI BRUIX
The activity in the different lines of work in this pro- gramme in 2015 has resulted in some relevant con- tributions which have increased knowledge of risk factors and oncogenic mechanisms of both liver and gastrointestinal cancer. The studies have produced diagnostic and therapeutic innovations which have led to modifications in the clinical management of
In colorectal cancer top level research intended to establish the effectiveness of early detection cam- paigns has continued. This was backed by the AECC and the Ministry of Health. In this context we should stress the nationwide COLONPREV and EPICOLON studies, intended to establish new strategies for pre- venting colorectal cancer in intermediate and high
patients affected by these diseases.
Knowledge of the molecular anomalies of hepato- cellular carcinoma and cholangiocarcinoma in liv- er cancer has been extended, in such a way that a rational biological basis for new treatments will be available in the future. Better classification of pa- tients must obviously enable a more rational design of therapeutic tests.
Greater knowledge has been obtained about the role of the mitochondrial genome and P1 type puriner- gic receptors in the retrocontrol processes which regulate the expression of nuclear genes connected with the failure of liver cancer to respond to phar- macological therapy. The role of biliary acids and their interaction with macrophages in the oncogenic transformation of cholangiocytes has also been dis- played.
On the clinical level, the first clinical trials with im- mune checkpoint inhibitors on patients with hepa- tocellular carcinoma have been started with some promising preliminary results. Leadership has been maintained in phase 3 tests evaluating agents such as tivantinib and regorafenib so that the results can be made known in 2016.
In the field of locoregional therapies the evaluation in phase 2 and in phase 3 tests has been maintained with a leading role in the design of an international multi-centre clinical trial for evaluating the effective- ness of radioembolisation in patients with intrahe- patic cholangiocarcinoma.
risk-populations, respectively. The COLONPREV project is structured on the basis of a prospective, controlled and randomised study which compares the immunological detection of faecal occult blood, which constitutes the approach currently recom- mended in Spain by the Consejo Interterritorial de Sanidad, and colonoscopy. The results of the first round show that both approaches enable detecting the same number of cancers, with a lower rate of complications and better cost-effectiveness ratio. The COLONPREV study has led to several publica- tions which have enabled improving the cost-effec- tiveness ratio of early detection plans and stratifying the population based on the results of examinations and their genetic profile in individuals affected by family hereditary cancer.
22 I Annual report 2015 I CIBEREHD